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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:2218-2223, October 2005
© 2005 American Society of Neuroradiology

BRAIN

Does a Relative Perfusion Measure Predict Cerebral Infarct Size?

Tobias Engelhorn^a, Arnd Doerfler^a, Michael Forsting^a, Gerd Heusch^b and Rainer Schulz^b

^a Department of Neuroradiology, University Hospital, Essen and Erlangen, Germany
^b Institute of Pathophysiology, University Hospital, Essen and Erlangen, Germany

Address correspondence to Tobias Engelhorn, MD, Department of Neuroradiology, Erlangen University School of Medicine, Schwabachanlage 6, 91054 Erlangen, Germany

BACKGROUND AND PURPOSE: MR perfusion-weighted imaging (PWI) has been extensively used to quantify cerebral perfusion deficits after the onset of focal ischemia. The present study tested whether a relative measure of cerebral blood flow such as is obtained with PWI is sufficient to predict irreversible tissue damage following focal cerebral ischemia and reperfusion in the rat suture model.

METHODS: In rats, the middle cerebral artery was occluded (MCAO) for 1 hour followed by 1-hour reperfusion. Microspheres labeled with different tracers were injected into the left ventricle to permit measurement of blood flow at different time points: before MCAO, 30 minutes post-MCAO and 30 minutes postreperfusion. Absolute cerebral blood flow (CBF) was determined and relative CBF was calculated by comparing absolute CBF at each time point to baseline values before MCAO (relative CBF_B) or to corresponding contralateral areas in the noninfarcted hemisphere (relative CBF_C). Infarct size was assessed by 2,3,5-triphenyltetrazolium chloride staining.

RESULTS: Absolute CBF in vital tissue was 0.69 ± 0.07 mL/g/min. In partially and completely necrotic tissue, absolute CBF was 0.39 ± 0.05 mL/g/min and 0.30 ± 0.09 mL/g/min, respectively. Although there was a close inverse correlation between infarct volume and absolute CBF (r = 0.79), the correlations between infarct volume and relative CBF_C were poor (r = 0.21).

CONCLUSION: The present study revealed that absolute CBF is superior to relative CBF in predicting irreversible tissue damage following ischemia and reperfusion.

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